| NPI | 1801061916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ROBERT GAMBINO Director 516-887-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY X010987-1) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2012-08-24 |